Solutions for Misfitting Dentures: Addressing Common Dental Issues

Q: Solutions for Misfitting Dentures: Addressing Common Dental Issues

Hello： According to what you mentioned, another physician has improved the condition of your swollen and cracked lower lip, and there is a plan to create a new model. <br>If this physician and the original physician are working at the same facility or clinic, it should be easier

What are the corrective measures for improperly fitting dentures?

What are the corrective measures for ill-fitting dentures? Currently, I have replaced four upper anterior teeth and lateral incisors with all-ceramic crowns for aesthetic reasons.
After wearing the temporary denture for the first time, I reported to the dentist that my teeth appeared protruded, with the upper anterior teeth covering my lower lip, causing pressure that led to swelling and skin breakdown on my lower lip, as well as difficulties in pronouncing certain words and discomfort from the pressure on the existing tooth roots, which has been increasing in pain.
The dentist suggested that re-bonding and adjustments would suffice.
After repeatedly expressing the same issues, and following three adjustments, the problems persisted without improvement.
The dentist stated that he did not believe there was any protrusion of the anterior teeth and that the speech difficulties were merely due to initial adjustment, indicating that the pressure on the lips occurred only when my mouth was tightly closed, which normally lasts only 17 minutes a day, implying that my anxiety was the cause.
He then proceeded to fabricate the permanent crowns and proactively lengthened the denture for aesthetic purposes.

After trying the permanent denture for the first time, I reported the same issues, along with the fact that my lower teeth did not contact the inner edges of the upper teeth during occlusion.
The dentist suggested thickening and shortening the denture to improve the situation.
After the adjustments, the thickness increased, but there remained some space between the upper and lower teeth, and the length could not be modified further.
The dentist believed that the difference was minimal and not significant, attempting to persuade me to adapt to the situation based on his expertise.

On the third day of re-wearing the denture, the discomfort from the pressure on the tooth roots, the speech difficulties, and the skin breakdown on my lower lip prompted me to strongly request a change of dentist for a remake of the denture.
Another dentist adjusted the length, which improved the swelling and skin breakdown on my lower lip, and indicated that further thickening would be done to enhance occlusal fit and speech, followed by remaking using the modified model.
I suspect that there may have been an error in the initial dental impression, and I wish to have it remade, but the dentist denies this and refuses.

I would like to ask how I can improve the situation? I feel that the dentist is hoping and trying to persuade me to adapt to the current issues.
Thank you for your clarification.

Shuiyue, 40~49 year old female. Ask Date: 2020/11/03

Dr. Lin Jiayong reply Dentistry

Hello: According to what you mentioned, another physician has improved the condition of your swollen and cracked lower lip, and there is a plan to create a new model.
If this physician and the original physician are working at the same facility or clinic, it should be easier to address the issue.
Following the new physician's recommendations should help resolve your problem.
As for whether the initial dental impression was incorrect, leading to the need for a complete re-impression and a new try-in process, that will depend on the physician's experience to determine.

Reply Date: 2020/11/03

More Info

When it comes to addressing issues with ill-fitting dentures or dental crowns, it is crucial to understand the underlying causes and the appropriate steps to take for resolution. Based on your detailed description, it seems you are experiencing significant discomfort and functional issues with your recent dental work, specifically with the four porcelain crowns on your upper front teeth. Here’s a comprehensive approach to tackle the situation.

Understanding the Problem
1. Misalignment and Aesthetics: You mentioned that the crowns appear to protrude, causing your upper teeth to cover your lower lip, leading to discomfort and even pain. This misalignment can affect not only aesthetics but also your ability to speak clearly and chew effectively.

2. Physical Discomfort: The pressure on your gums and the discomfort you feel when wearing the crowns indicate that the fit may not be correct. This can lead to inflammation and pain, as well as issues with your oral health.

3. Communication with Your Dentist: It seems there has been a disconnect between your concerns and the responses from your dentist. While they may have suggested adjustments, the persistence of your symptoms indicates that the solutions provided have not been effective.

Recommended Steps for Resolution
1. Seek a Second Opinion: Given that your concerns have not been adequately addressed, it may be beneficial to consult another dentist, preferably one who specializes in prosthodontics (the area of dentistry that focuses on designing and fitting artificial replacements for teeth). A fresh perspective may help identify issues that were overlooked.

2. Document Your Symptoms: Keep a detailed record of your symptoms, including when they occur, the severity of the discomfort, and any changes after adjustments. This documentation can be invaluable when discussing your case with a new dentist.

3. Request a Comprehensive Evaluation: During your next dental visit, ask for a thorough examination of your bite and the alignment of your crowns. This should include checking the occlusion (how your teeth come together) and ensuring that there are no underlying issues with your gums or jaw that could be contributing to your discomfort.

4. Consider Remaking the Crowns: If the new dentist finds that the crowns are indeed ill-fitting, they may recommend remaking them. This process should involve taking new impressions and ensuring that the crowns are designed to fit your mouth accurately.

5. Discuss Material Options: Sometimes, the materials used for crowns can affect comfort and fit. Discuss with your dentist whether there are alternative materials that might provide a better fit or feel more comfortable.

6. Follow-Up Care: After any adjustments or remakes, ensure that you have follow-up appointments to monitor how your mouth is adapting to the changes. This is crucial for addressing any new issues that may arise.

Preventive Measures for Future Dental Work
- Choose a Qualified Specialist: When considering dental work, especially for crowns or dentures, ensure that you are working with a qualified prosthodontist who has experience with similar cases.

- Ask Questions: Don’t hesitate to ask your dentist about the process, expected outcomes, and what to do if issues arise. Clear communication is key to successful dental treatment.

- Regular Check-Ups: After receiving new dental work, schedule regular check-ups to ensure everything is functioning as it should and to catch any potential issues early.

Conclusion
Navigating dental issues can be frustrating, especially when discomfort persists despite attempts at resolution. It is essential to advocate for your oral health by seeking second opinions and ensuring that your concerns are taken seriously. By following the steps outlined above, you can work towards finding a solution that alleviates your discomfort and restores your confidence in your dental work. Remember, your comfort and health should always come first in any dental treatment.

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